Q: Where can I have my dialysis access checked? Where can I check my fistula or graft? Where can I fix my clogged or clotted dialysis fistula near me?
A: At Advanced Surgery Center, your Fistula, Graft, or Catheter can be checked.
Q: Is there a dialysis access center near me to check my fistula, graft or catheter?
A: Advanced Surgery Center is nearby many locations and easy to get to in Fort Lee, New Jersey.
Q: What Interventional Nephrologists or Vascular Surgeons are there in Bergen County?
A: Dr. Alexander Parpas is an Interventional Nephrologist with 5 years experience and over 15 years in the medical field, he works with many Vascular surgeons and can efficiently and accurately diagnosis and treat your dialysis access needs.
Q: How often does my fistula or graft require evaluation?
A: Your access should be checked during each dialysis treatment. If the staff at your center see a problem they will refer you to our surgical center for evaluations and possible angioplasty (“cleaning”).
Q: What is a fistulagram or angiogram? What is an angioplasty?
A: An angiogram is a diagnostic picture of your vessels starting from the fistula or graft. If there is a stenosis (narrowing of the vessel) or clot is present, an angioplasty is indicated. An angioplasty, sometimes referred to as cleaning the access by patients, it is when a balloon is used to fix the narrowed part of the vessel.
Q: How long does an angioplasty procedure take? Will I be awake during my procedure? Can I drive after my access procedure? How soon can I return to dialysis after my procedure?
A: On average the procedure will take 15-20 minutes. You are awake but sleepy and sedated. We do not recommend driving or operating heavy machinery after the procedure. In almost all cases you can go to dialysis after.
Q: What kind of problems can happen with my fistula?
A: Normally your access may make buzzing or humming noise that’s a good sign the blood is flowing. When there is a narrowing (stenosis) somewhere in your access. You may experience these symptoms: prolonged bleeding >5 minutes, growing aneurysm (bubbles), ulcers, scabs, infection, swelling of the arm, face or chest, clotting or clog, a hard access, no buzz or thrill, hand, arm or shoulder pain, machine alarming, poor clearance (not making your numbers).
Q: What is a Declot or Thrombectomy?
A: When a fistula or graft is clotted the blood stops flowing. You can no longer feel the buzzing thrill of the fistula or graft because the clots and stenosis. Thrombectomy and angioplasty is likely indicated.
Q: How can I fix my clotted fistula? Do I have to go to the emergency room if my fistula or graft is clotted or there’s no blood flow?
A: No, most of the time, you do not have to go to the hospital or emergency room for a clotted fistula or graft. You can be evaluated and treated as outpatient at Advanced Surgery Center in Fort Lee, NJ.
Q: When should I seek emergency care?
A: If you are bleeding from your fistula, graft or catheter, have chest pain or are unable to breathe well. If you hand becomes cold and painful, you should be evaluated in the emergency unit at a Hospital. If you have missed 3 or more treatments of dialysis you are at severe risk and should speak with your nephrologist.
Q: What is a dialysis catheter?
A: Tunneled dialysis catheters are usually placed on the right side of the chest and are tunneled under the skin, there is a cuff on the tubing that stays under the skin. This cuff stops the catheter from coming out or infections from going in. Once the cuff has seal off the tunnel you may shower but limit water contact and do not submerge under water.
Q: Why is my dialysis catheter not working well? How long can I have a catheter? My catheter is starting to come out, can I push it back in? What if my catheter falls out? Why does my catheter site painful or itch?
A: Clots at the tip or within the catheter will sound the HD alarm and is a sign of a problem and should be evaluated for replacement. Catheters can last several years if maintained properly. Never push your catheter in, tape it down and go to the access center immediately. If the catheter cuff is exposed you are at risk for infection and it may fall out, the catheter should be exchanged.
Q: What is Peritoneal Dialysis (PD) and how does it work?
A: Peritoneal Dialysis is a dialysis treatment using fluids in the abdomen to help filter your blood. To do peritoneal dialysis a catheter (tube) is placed into the empty space in your belly allowing fluids to fill and drain from your abdominal space.
Q: Why do I feel numbness and tingling in my hands? Why are my fingers turning blue or white? What if my hand suddenly becomes cold, blue, or painful?
A: Blood going to the hand can be "stolen" by the access due to excess flow and this is called steal syndrome. Steal syndrome can be a major concern and may need immediate attention especially in extreme cases where there is cold, pale, blue, painful hands.
Q: Why is my arm swollen? Why is my neck swollen? Why is my chest swollen? Why is my face swollen? Why is my hand swollen? Why are the veins on my neck or chest getting larger?
A: These are signs that there is a significant narrowing of your vessels from your access that likely require angioplasty.
Q: What is a Percutaneous Fistula Creation or Endovascular Fistula Creation?
A: This is a minimally invasive procedure (no cutting) that can be done in the outpatient setting in minutes. They typically mature (become ready for use) in 4-6 weeks similar to a surgical open creation.
Q: How long before I can start using my fistula or graft?
A: Fistula usually take 4-6 weeks to mature and may need “maturation” procedures, this procedure helps the fistula become the appropriate size required for needle cannulation. Newer Grafts may be used in 24hrs but most need 3 weeks.
Review the below literature from National Kidney Foundation by clicking the site below.
https://www.kidney.org/kidney-topics/hemodialysis-access
https://www.kidney.org/sites/default/files/11-50-0216_va.pdf
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